Mortality from breast cancer has increased among American Indian (Al) women. Despite this alarming reality, Al women have some of the lowest breast cancer screening rates. Only 37% of eligible Al women report a mammogram within the last year and 52% report a mammogram within the last two years compared to 57% and 72% for White women. The experiences and satisfaction surrounding mammography for Al women likely are different from that of women of other racial/ethnic groups, due to cultural differences and limited access to Indian Health Service sponsored mammography units. The overall goals of this study are to identify and understand the mammography experiences and experiential elements that relate to satisfaction or dissatisfaction with mammography services in an Al community and to develop a culturally-tailored Al mammography satisfaction survey. The three project aims that will be used to guide this work are: 1) To compare the mammography experiences and satisfaction with mammography services of Al women with that of Non-Hispanic White, Hispanic, and Black women, 2) To develop and validate the psychometric properties of an Al Mammography Survey, and 3) To assess variation among Al women's assessments of their mammography experiences and mammography service satisfaction. Evaluations of racial/ethnic differences in mammography patient satisfaction have received little study, particularly among Al women. As such, qualitative study is uniquely suited for an initial examination of their experiences because it will allow for a rich and in-depth identification and exploration of satisfaction elements. This formative research is an essential step in the development of a validated and culturally tailored Al mammography satisfaction assessment.